Role of autoimmune disease in the young with cancer

The CRBCM has grown to a larger Oncology Clinic
but its interest with Breast Cancer has sharpened.
It is clear that Breast cancer in the young women is clearly associated with not only to obesity as claimed by Pundit but to undefined, undiagnosed autoimmune syndromes.   The link to autoimmune syndrome appears to be stronger despite the fact that it is also the more difficult to ascertain.   There appear to be no consensus among Immunologist as what should constitute a basic work-up for autoimmune syndromes.
There are many autoimmune syndromes and all seem to lead to cancer predisposition.   Autoimmune disease detection remains the biggest challenge and mostly not completed at the time of diagnosis of cancer in a young individual.  Therefore it remains ignored.  In our practice, the basic screening include :
1.ANCA
2.Anti-Saccharomyces Cerevicea for detection of early Colitis and related colon cancer
3.Anti CCP
4.Rheumatoid factor
 5.and ANA
(rarely anti-Smith)

rarely we add the anti-RNP for possible connective tissue disorder.


It is clear that a full Lupus panel would be advised but cost could be prohibitive and, in these days in age, the insurance companies limit our exploration.
Quickly one will note that some tests are "confirmation" test while other are "screening" tests.  In our hands, experience show that many times these so called confirmation test could be positive while the screening test is in the "high normal".  In these instances, suspected diagnosis is  made.  It belongs to the Rheumatologist to actually treat accordingly.

With this approach, countless of Lupus positive young women are found among our Breast cancer patients.  We will publish our findings soon.   The interest is also in the frequency of Bilateral findings of Breast cancer among these patients.  Care should be exercised while following these young patients.
 The patient with Antisaccharomyces  calls for attention to early colonoscopy.  Countless young women approached this way are found with Polyps and at least one patient was found with a non invasive colorectal cancer.   Certainly this antibody will be talk about in the future as we discuss increasingly about early colonoscopy.  (As we speak, I have a 49 year old found with stage IV colorectal cancer who is Rheumatoid Factor Positive and anti-Saccharomyces positive).
In the absence of clear autoimmune syndrome by lab, suspicion is kept in patient with sudden profound fatigue that remains explained, anxiety or Depression, insomnia, and low Vitamin D
arthritic pains and sometime Hypothyroidism.  Those will colitis will report bouts of unexplained diarrhea, or constipation, or hx of Gallbladder disease including history of cholecystestomy  (and ITP).  These are present in autoimmune syndromes.
The reason for the association of autoimmune disease correlation with early cancer remains a mistery and is an area of intensive research.  We are on it.  From "proximity of genes" and something to do with "check points".  We will update you as the thing unfolds.






 

Prayer for the common world

Please do not let me leave the world the way I found it
please give me hope and strength to change the things that I found in a more evolutionary way
so that tomorrow be built not on the things that I found but rather on the things that I was able to build.
Let me not sit here but keep moving things the way it ought to be
because my time should count for some thing in the evolution of the world which is evolving in a ever changing Cosmos.

Rare tumor

In September 2016, a 50 year old Hispanic female was referred to our clinic for an encapsulated mass to the left side of the Vulva.  On CT, the mass seems to contain fat, encapsulated with solid content extending into the labia.   The radiologist felt it could represent a Liposarcoma.   Tissue diagnosis however suggested an Angiomyofibroblastoma.
Surgery was recommended, and on December, 01,2016 she underwent
a resection of the mass which was 22 x8.5x4.0 cm
the tumor was weekly positive for Desmin
strongly positive for Vimentin
ER positive
PR positive
 all other tested immunochemical stains were negative

The case was referred to Massachusset General Pathology for review
there was no  other metastatic lesion
and surgery confirmed the diagnosis

what to do now for this patient
concerns:   The disease is benign- Observation was advised
                   The tumor is too large, and no mention of full removal despite the encapsulation seen on CT.   should she have Radiation to reduce local recurrence.
ER and PR were positive, should we give Tamoxifen now or wait for a recurrence?
The disease had some "Angio" component, will it benefit from anti-EGFR treatment in case it recurs?

Options in Renal cell cancer treatment

First Line Metastatic disease:
-----------------------------------

1.Sutent
2.followed by Nexavar in those who cannot tolerate Sutent
3.Sutent 50   has been equivalent to Lapatinib 800 daily
Other first line Bevacizumab +/- Interferon
Temsorilimus
But if you consider Bevacizumab think of combining to Alezolizumab (there is Synergy)
4.Other 2nd line:
---------------------

4.a.  Everolimus
4.b.Cabozantinib

Cabozantinib has been compared to Everolimus
there was a 33 % reduction of dying with Cabozantinib

4.c. Other alternative in 2nd option is Nivolumab which has risen to standard second line after Sutent
Nivolumab has been found superior to Everolimus

4.d  Levantinib
which has been sometime conbined to Everolimus
this combination has been superior to to each drug used separately.

4.e future trial Nivolumab +  Ipilimumab

4.f.  Axitinib

OPTIONS IN TRIPPLE NEGATIVE BREAST CANCER

1.CARBOPLATIN +  VELIPARIB

2.ABRAXANE    +   CARBOPLATIN

3.ADRIAMYCIN  +   CARBOPLATIN    +  TAXANE

WITH TAXANE WEEKLY X12
WHILE CARBOPLATIN IS GIVEN WEEKLY X 6

4LESSER ALTERNATIVE :   GEMZAR  (1000)+  ABRAXANE(125)


5.XELODA



OF NOTE: THE MORE THE NUMBER OF NODES INVOLVED, THE MORE THE BENEFIT OF ANTHRACYCLINS



FOR  METASTATIC DISEASE
1.ADD ENZALUTAMIDE  IN TRIPLE NEGATIVE WHICH HAS AN ADROGEN RECEPTOR POSITIVE, THERE WIL BE A 9 MONTHS BENEFIT

2.TARGETING GLYCOPROTEIN

3.PI3K
USE MTOR INHIBITOR
PACLITAXEL   +   AKT INHIBITOR

4.SNDX
ALEZOLIZUMAB  (1200 )+  ENTINOSTAT:   19%rr

ALEZOLIZUMAB  +  ABRAXANE

5.PARP INHIBITOR
OLEPARIB 400 MG PO BID
RUCAPARIB  600MG PO BID

GENETIC MARKERS AND RELATED MEDICATIONS FOR TREATMENT

IF A TUMOR EXPRESSES

PICA/PTEN--------------------------------------------EVEROLIMUS
TOP3A--------------------------------------------------DOXORUBICIN
PARP1---------------------------------------------------OLIPARIB CISPLATIN
VEGEF--------------------------------------------------BEVACIZUMAB
TYMP----------------------------------------------------XELODA
ROS1-----------------------------------------------------CRIZOTINUB

PROGRESS IN BREAST CANCER TREATMENT

Progress in Breast Cancer treatment:

1. ER Positive

These tumors of course can be treated with Tamoxifen in premenopausal patient (some have required 2 years from last Menses to consider someone Post Menopausal) and Aomatase Inhibitors (AI) for post Menopausal.

In those with recurrent disease (or progression )
Anastrazole or Fulvestran being strong suggestions.
But the game has been improved as more options have been proposed
1.o.   Palbociclib(125) +   Letrozole(2.5)
check day 14 CBC for frequent episode of Neutropenia and fever
time to progression with this combination 22 Vs 14 months

2.o  for the 50% who will not respond to the first option
consider Everolimus + Entinostat
3.o  Everolimus  (10) +  Exemestane

watch for stomatitis,fatigue,Dyspnea,Hyperglucosuria, LFTs, and pneumonitis

4.o   Palbociclib   +   Fulvestran
5.o   Monarch 1 may have proposed Abemaciclib as an option in these instances
6.o   Abemaciclib can be combine with either Letrozole or Fulvestran
7.o   don't forget that Entinostat can also be proposed in combination with Examestane


These same agents can be used in Neoadjuvant setting, when confronted with Locally advanced disease for 16-18 weeks prior to definitive surgery.

Is the black hole evidence of the existence of parallel universe

We all agree that black hole exist, they suck universal objects such as planets and suns and moon
but for where....matters sucked will go where?
it is true that we started off as a big bang
or was it a big bang, did we come from the other side of a black hole?   in a parallel universe
is the big bang the explosion that follows from the furnaces of a black hole...is the black hole the origin of the dark natters that seem to offset the rules of Physics...indeed it has been calculated that in its tourbillon of a galaxy, matters should be moving faster while at the periphery things should going a lot slower ...but it is not thru as peripheral bodies of a Galaxy are like charged up by "dark" matter as they spin at exhilarating speed ...black (?from black holes)  matters seems to foil the predictions....black matter is Energy...may be by mixing with tangible matters at the periphery of Galaxies...but where things go after an absorption by black holes...do they just vanish or may be transformed in true black matters...or come  out the other side in a parallel universe?...if it is true that nothing is created all transform...where things go after passage through the black holes...?

The promises at CRBCM

Dear Dr. Kankonde,


We will forward the kits for HLA typing of his sibs.
I will inform our Cell and Gene therapy unit.


G.

From Baylor University to CRBCM	2:42 PM (18 hours ago)

"Augmented Hyper-CVAD based on dose-Intensified Vincristine, Dexamethasone, and Asparaginase Therapy"  Katarjian et al...

This is what Baylor University has recommended for our patient with refractory ALL. (peristant MRD)  we thank them...

If all will end

According to most astrophysicists, the world will end in an explosion caused by comet that will be large enough to cause cataclysmic shifts how ever you can imagine them...but with all evidence this all could be avoided at least theoritically...because the velocity and masses of the incoming meteorite could be predicted years ahead, science should be ready to "deflate" the speed of the incoming and arrange for a "softer" landing.    Today we see vehicle sent to mars covered in Balloon to avoid a tough impact on Landing, why can't a comet be assured a soft unnatural  landing...on Balloons or after repeated deflagrations and deflations....we need to start thinking about this now and not accept the fate of the dinosaurs...In principle, all this is possible, if we know how to govern the forces already present in the Cosmos.    We know a ray of some sort can pulverize anything of in its path...ie a ray from a Pulsar, can we have such a ray...can we maximize laser to bombard incoming meteorites...don't just shoot down satellites...but sizable meteorites aimed at earth...that may breach our atmospheric layer of protection...should the human race be doomed because we played the victims by accepting the fate of our planets...the forces that led to our existence have designed us to dominate the Universe and Cosmos...they did not tell us how but it is in our souls, our minds to figure it out...Today we look upon the sky to see the distant sky...but we know we can one day "warp" through the interstellar like going to Walmart...The fact is earth itself is traveling around the Sun at thousands of miles just by using gravity toward the Sun...who say we cannot "sling shoot" into Cosmos inside a "Dirigeable"toward new worlds...It is for us to make this happen...our trip started with the comet that brought us to Earth...Let's not stop here!...

life a continuuum of things...B

The news from space is still coming in
it is new for me but certainly old for those who have been following it closely
it is a time striking  and at the same time soothing
striking that life was started by some kind of an explosion that caused creation of gamma rays
soothing that we are probably the extra-terresterial we have been looking for brought in by a comet...and that our composition is same as our sun, we can now relate...which soothes my heart...
the same information tells me about preliminary notion of quantum physics such as quantum enigma...
Delving into the minuscule after looking at the sun makes perfect sense because we all part of the same continuum...from the particules making the neutron to the macroscopic us and the sun to the making of cosmos ...It is in this context that we can understand the intricacies of genetics...and its causing of diseases such as cancers.   The notion that Helium is created constantly in our Sun through bombardement so to speak by activity of electrons, creates in effect matter elements similar to what we are made of at a rather more complex state but yet the same matter...similitude at molecular level explain our susceptibility...If our DNA has Cytosine in its composition for example, any compound which react easily with Cytosine, will have implication at DNA level...directly...(see how easily products in a cigarette smoke can act directly on DNA...)  this where the crux of the matter is as it goes back to...our simple component...similar to the Sun...
then goes this notion that different atoms have a symetrical atoms distant away and no matter what distance there is similarity in their activities (the doppelganger effect)...this goes deep...that any of us has a doppelganger... spooky in a way....but I believe it....what this tell us...

In cancers, It is remove the break and release!

Many cancers are allowed to occur when Breaks in genetic pathways are removed
and abnormal proteins are being released (or formed) as a result of failures.
Of course one of the way the gene acting as a break failure is through Mutations  (of course heterozygosity, missing or omission, or blockage will be the other ways of failing)...The failure is not alone...subsequent consequences result in the pathways leading to aberrations that ultimately engage the cancerous process.
These consequences end up amplifying a normal or abnormal gene (c-Myc) resulting in amplification of other genes in the pathways...and cancerous disease develop.   It is important to note that while this is happening, mechanisms to protect this dangerous development also are engaged...Mucus is formed to protect the cancer from detection (ie Colon cancer cells) and most importantly genes such as the PD-1/PDL-1 are also formed to hide the process even more deeply ...
say you want to check for Lynch Syndrome, you will find that the APC gene which is Mutated is not stopping the Wnt-signaling pathway which leads to "mutated proteins" or dysfunctional proteins which could block the Beta-Catenin from transcribing more resulting Oncogenes...This is an early event in the cancer development...making the cell loose the sens of containment and shape, a polyp will result...

Few GI update

*capecitabine with Avastin now a standard first line in elderly with Metastatic colorectal cancer
*S1 better then Gemzar in adjuvant setting in Pancreatic cancer
a drug that was for long time not available in the USA...
* and now what was suspected is now confirmed that Cisplatin-FU could be a second alternative to Mitomycin-5-FU as Radiation sensitizer for Anal Cancer...
*IN GE-junction Cancer, EGFR no
and Her-2 yes but with Trastuzumab (not Lapatinib)

life, a continuum of structures

Life secret is hidden in several dimensions
distance among the suns and various planets, continuum of life structures, limitations of our minds, limitations in our lives etc...
I was talking to someone about how far is Orion, he tells me "I don't have to worry about this, I will never see it"...this attitude let the secret get a second wind...particularly at the time where "New Horizon probe is penetrating the intercelestial world beyond Neptune,  even scientists were lost  (lacking an objective for their probe)  until the new glacial object in this space became an objective for 2019.  In the same time, beyond the atome and electron, even smaller particules are being discovered  while we still don't know if our mountains, full of rocks, are "alive".   We can move while trees can't but they live longer than us...Methane is a proof of life on earth, but there is full of Methane on Titan a moon of Saturn, a planet which is still surrounded by moving "stones" which make this planet's belt and we recall our own history that earth too was surrounded by water and heavy stones that shielded the planet from sun rays and resulting cooling led to the disappearance of the dynosaurs...it seems like Saturn is still in that transition after being hit by a moon or a comet...we can still see the belt today...some speculate people from Saturn saw the comet coming and some may have mooved to Titan, therefore the Methane there...plenty of organisms may have survived there, those who can survive the cold...underwater...on Titan...aquatic life you see!   you have to go under the waters to meet them!...the methane is a proof of life...some speculate their membrane is not like our with bilayer lipid but "Methanic"... to sustain the cold...indeed they are so far away from the sun.  they get the sunlight but not the heat!   Beside there is time when they get eclipsed by Jupiter...the bigger planet...likely this is rare since these things spin around the sun at different speed...what an eclipse that must be...
In this world when we live less than a century...things have been happening for billions of years
so has to keep life secret beyond us...and trees which lives longer can,t tell us...can't write these things down to transfer the knowledge...our savants die off in the "flower" of their ages...living the deep mysteries of life untackled!...the mystery lives on...unimpaired!!!

Research has restarted
This time with completion of our random selection of sera
Indeed 64 patients,friends and neighbors have volunteered their blood samples for for random gene mutation testing.  7 mutations were selected based on availability at UTEP  of Antisera.
c-Myc, Survivin, Cyclin B1, HCC-1, NPM1, P53, and p62 were randomly selected

We are Published!

In the Journal of Oncoimmunology
the article was submitted in Sept 2015
and peer reviewed in December 2015 when it was also Accepted
will be published under "original study"

"Serum MDM2 and Anti-c-MYC autoantibodies as Bio-markers in the early detection of Lung Cancer"
with DR Kankonde, and DR Zhang from UTEP
this will launch CRBCM as Center of genetic research!
The study was completed in established cancer patients
we need to run a similar study in smokers!
the challenge is on!


We cannot thank enough those who have made this research possible
1.MD Honors/World ONE London/UK,which provided initial fund
2.Tissue Bank, University of Virginia,Lung Cancer  Biospecimen Network!
3.Review Board at University of Texas at  El Paso
and DR Zhang team and in China DR Bao-Fa YU


Thank you a all lot!

Dark matter

one controversial matter in astro-physics is the existence of dark matter
but when you think about it, it seems to me that the existence of dark matter is evident
as there is a "no" for a "yes".   Evidences accumulate that increasingly well known phenomena may be explained by the existence of dark matter.   For those in the extreme, the moon circling around the earth is linked to the existence of "waves" of dark matter.   Any circling body around the sun may be driven by dark matter to not fall out. That force of attraction toward the earth center (pesanteur) is govern by dark matter.   one other not well publish fact is the center oriented fact when a light goes out in a dark room, luminosity goes out from periphery to the center (and never the other way) as dark matter moves in....The moon influence the oceans through activity of dark matter...For some the strength of dark matter is concentrated and represented by "Black holes" in Cosmos (while the force of "white matters" is represented by motion driven organisms...At the center of this line of two extremes are motion mess living such as trees...some wonder if rocks are also "living" in a philosophical way.

I come to think of it, if the rock was "living", it may make sense that there are so much rocks into the planets...

Chromosome Translocation, an old scientific curiosity

From Myelodysplasia to most cancers including T cell lymphoproliferative disorder, scientific readings continue to report how chromosomal translocations have such a prognosis meaning for our patients.   They go on to tell us how "breakable" these locations on the chromosome are...
"Loss of Heterozygosity (LOH) is identified in 30 to 60% commonly at 9p,10q, 1p, and 17p"...in cutaneous T cell Lymphomas  (Kuzel et al)
what most literatures does not report is just as important, but may be more important, is the specific gene really involved by the translocations.
for 5q deletion syndrome, a Myelodysplasia, the gene appears to have been discovered so that we can develop new Medicine aside from Revlimid, and may be understand a little more what induce the disease and what can be done more specifically...defining what a chromosomal deletion involves in terms of gene missing or criss-crossing appears more urgent now.

"Recently,RPS14 has been identified as a likely candidate gene involved in the 5q-syndrome" (ASCO)

Striking Facts

*Mutation of BRAF has been seen in all cases of Hairy cell Leukemia
Is that mean that Cladribine  and Pendostatin need to be used in BRAF positive Melanoma
or is this a different BRAF

The opposite is it true? should we use dabrafenib in Hairy cell Leukemia

Are they localized Mutations that differentiate the 2 types of BRAF Mutations...

*As it stands,  CLL treatment include
-FCR
-Chlorambucil +/- Rituxan (or Ofatumumab/Obinutuzumab), R-CHOP
-Alentuzumab
-Rituxan Bendamustine
-Idelalisib, the anti PI3K
- CARTs targeting CD19

Today's GIST

1. Standard treatment
is Imatinib for 3 years for patient with high risk of recurrence
those with Exon 11 in the KIT gene will respond the best

2.The 2nd line is Sunitinib
3.Those who resist these meds, well Regorafenib may work
check your FDA recommended list

More and capable Telescopes

when it comes to observing the Universe,  with our current means, comparison has been made that
we can only look from our stand points.   Briefly its like looking at a room from a "key Hole"
only more "Hobble Telescopes" are needed to look everywhere.   Let say the Batteries can also be improved to use Nuclear Batteries instead of the current which may last 30-40Years...More lasting Batteries are needed.
Same goes from genes, cellular Telescopes will be needed one day to map up the many interactions going on in the cell....

Death Center

*There is nothing without substance
for smoke to exist there must be fire at origin
and since death is a phenomena, a death center must exist
so where is it in a human body
everyone including this author believe that it is in the Brain
It is irreversible, once launched or engaged.  No one survive it as if the "consensus" of all cells is to "remain dead" once the message is received.  One would speculate it could be in the lungs, however
hypoxia message needs to be received by the Brain for death to occur.
If you are falling from the sky or the skyscraper, you will be dead or unconscious prior to hitting the ground.  Once again your brain will give up first....
you can harvest any other organ but the brain so far...
The counter to this is now:  can we act directly on on the death center to avoid dying?
"are consensus genes" be considered involved in the death process.   Are people who live longer have mutations in the "consensus" genes.  Can we prove that intercellular communications  are involved in the death status.  Can we ultimately interfere with death?  block it for happening?   If really smoke assumes there is fire, the there are genes that directly cause a death state.   And if there are genes...

*With billions of suns in the Galaxy, it is almost impossible that there is no other life out there...
yet we will not know for one reason,  worlds are kept too far apart...the suns we can see (as stars) are too far away sometime 3 to 4 times the distance to our Sun.   No one can reach other sun's planet alive with our current vessels.   So we will not meet our cousins on other planets any time soon...but they are there wondering the same...denying their existence...is denying our own existence ...

Important Updates

*90 % of lymphoplasmacytic lymphoma have L265P
*Rituxan-EPOCH back into Burkitt lymphoma treatment
*the infamous S1 better than Gemzar in adjuvant treatment of resected Pancreatic cancers!
*BRAF Mutated colon cancer needs the famous "Kitchen sink" thrown to them-FOLFORINOX-Avastin

Lets back up a bit

It is hard to imagine that as you are reading this, you are indeed traveling at 63,000 miles around the Sun but it is true.  We should be dizzy but of course there are things that keep us from dizziness, our relation to Earth which is steady, the Atmosphere that enclosed us and keeps us safe and of course respectable distance of other planets and moons that although changing but at controllable speed.  Yes you look up the friendly sky and Orion is moving at slow pace...to eventually disappear for months that we can not see it...from one particular location at least...
But the Mystery of life goes on...suffice is to say that what we know of the Universe is not controversial but at least understandable...It is however progressing and always expanding.  New fact has come up to change our understanding...scientists had noted an object the size of a "moon" beyond Pluto...the object was visible for a while than it  disappeared.   But after a "while", the object came back then left again in sight...than it dawned on them that the object was rotating around some planet beyond pluto.  while Earth is turning around the Sun on an orbit that takes it 365 days to complete, This planet could take 1 million years to complete its orbit?  Is this true?  I guess we are lucky to have seen it...Suffice is to say that this is challenging our current understanding of the "Universe"...
Are there more planets beyond...I strongly believe so...until we intersect with another sun's planets and there are billions of suns in the Universe...In our own Galaxy-The Milky way, there are millions of suns...
That brings up the second question
Around each sun, there are planets
and if there are suns it means they produce energy for their planets and there must be planets that enjoy the same circumstances and condition as Earth,  meaning there must be life somewhere else as true as we exist!   However, don't expect them yet...we do not have the mean to reach anybody...don't look for life in some clusters...It is there in the Universe but so far away we can't reach it yet...
let's however reorient our search, find a sun and its planets, then locate the planet with the closest similarity with conditions on Earth and voila !   Here are our distant cousins!   watch out, they may not like us....Distance keeps us apart...you may die before reaching there with our current means...

The Universe secret is kept by the current distance to anything...the sun to Earth is 93,000,000 Miles
but the distance to some portion of Orion is 3-4 times that.   It takes 8 minutes for the sun ray to reach us, and close to half an our for Orion to become Visible...Ladies and gentlemen, you will die before reaching any of those worlds...

Views on Colon Cancer Prevention

The frequency of occurrence of Colorectal Cancers is attracting the attention of Researchers
It seems though that the occurrence of Cancer in the Colon seems to be linked
to an inflammatory process that get out of hands.   A Cytokine storm seems to be involved
in the process.   The proof is there.   Most anti-inflammation medications seems to reduce the frequency of cancer occurrence (Aspirin, in the latest study).
should we monitor the NFkB gene pathway and amplification in colon cancer
we should surmise that error in early diagnosis of certain inflammatory bowel disease (IBD) leads to Colon cancers.    Meaning that improvement into the diagnosis of inflammatory bowel diseases would reduce the frequency of this cancer.
should a CRP (C-Reactive Protein) be included in the screening of Colorectal cancers
should increase of IL4 help in prevention of colon cancer  (stimulation of CD124)
also follow TRAF genes and IKKs

In a way should we inject high dose of IL4 to prevent Colorectal cancers?
Is partial Colectomy at 50 a viable prevention mechanism for Colorectal cancer? (how about in those with family hx or elevated CRP with IBD)

FROM ASCO:
"The benefit of Aspirin as a secondary prophylaxis in patients with resected Colorectal cancers appears to be linked to the presence of PIK3CA mutations (Liao)"

A second look

Can we disrupt this through the UPF-1
"
Nonsense-mediated mRNA decay (NMD) is a surveillance pathway that exists in all eukaryotes. Its main function is to reduce errors in gene expression by eliminating mRNA transcripts that contain premature stop codons.^[1] Translation of these aberrant mRNAs could, in some cases, lead to deleterious gain-of-function or dominant-negative activity of the resulting proteins.<sup>[2]"

Can this have a major impact in Sarcoma?</sup>

It just follows therefore

It Just follow therefore that IDH-1 would be a Biomarker for use of
Temodar and 5-AZAcitadine or Decitabine for Gliobastoma
and may be adding Ifosfamide or Etoposide for Leukemia and sarcoma (Chondrosarcoma) that is positive for Mutant IDH-1.    (and wild type TET)

In life, All go in pathways

If you understands that life is hidden in pathways, you know half of the truth...and yes if you can touch A and B you may finally reach C and later on Z.   The price is really how much perspicacity you intend to put up....and how much surprises you intend to unveil!
The Brain is hidden in the skull, and lives of Oxygen and sugar (no transformation of fat here if any).  Therefore gene that intervene in Oxygenation and de-Oxygenation are critical.  A  little known gene called IDH-1 gene is important!
"The protein encoded by this gene is the NADP⁺-dependent isocitrate .... "Role of isocitrate dehydrogenase 1/2 (IDH 1/2) gene mutations in human tumors"."  wikipedia

This gene most found with the Mitochondria and probably the protosome intervene in the detoxification of the cell.  But why is this gene important in the all scheme of Brain cancer and leukemia.  The point is to ultimately find the connection of this gene with how much it is linked to expression of genes.  Indeed remember many gene messages are hidden by methylation.Well methylation is a phenomenon that is very NADP like or dependent phenomenon.   Therefore Methylation of genes within the Brain cell is very affected by IDH-1 gene mutation.   IDH-1 will involve Cytosine based molecules such as TET gene, the initiation point of Methylation/de-Methylation of genes...Just imagine if this happen in a Telomere (which affect aging)...the cell all of the sudden will have its   aging changed or tempered with.   This is happening in both Leukemia and Brain cancer...and may be certain Sarcomas.

Life is a continuum...Starting from particle before the atoms, How this is linked to planets and into the Universe remains a question that goes deep into the truth of life!

Temodar and 5 AZAcitidine works in these diseases...proof in the pudding....

And it goes on

With millions of suns in our Gallaxy (the Milky way )chances are there could be
a earth like life comparable to ours.   But given the randomness of Circumstances that need to be met for our existence, the chance of finding other human beings remains remote.
Water, Oxygen and right composition of Oxygen based gazes need  to be gathered to lead to us like beings.
and why Dinosaurs did not return after the earth return to life,
because evolution occurs one way or the other given the circumstances?
So imagine one particular planet where Helium was the predominant gas,  the organism that will grow if any, may be the yellow man or green man that may result...or is it another dinosaur that will not survive even if we meet!   now come the question, should we meet at all?
I keep looking for now into Orion!

It gets complicated

from Myriad"Myriad’s newest companion diagnostic, myChoice^TM HRD, is an algorithmic measurement of three biomarkers associated with homologous recombination deficiency, combined with next-generation sequencing of the BRCA1 and BRCA2 genes in the tumor.  The three biomarkers, loss of heterozygosity (LOH), telomeric allelic imbalance (TAI), and large-scale state transitions (LST), have all been individually shown to be associated with BRCA1/2 deficiency.^1"